Basic Information
Provider Information
NPI: 1689645855
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAPPAS
FirstName: ZINON
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 86 THOMAS JOHNSON CT
Address2:  
City: FREDERICK
State: MD
PostalCode: 217024348
CountryCode: US
TelephoneNumber: 3016948311
FaxNumber: 3016943537
Practice Location
Address1: 86 THOMAS JOHNSON CT
Address2:  
City: FREDERICK
State: MD
PostalCode: 217024348
CountryCode: US
TelephoneNumber: 3016948311
FaxNumber: 3016943537
Other Information
ProviderEnumerationDate: 01/27/2006
LastUpdateDate: 06/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000XD53871MDN Other Service ProvidersSpecialist 
208100000XD53871MDN Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 
208VP0014XD53871MDN Allopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
208VP0000XD53871MDY Allopathic & Osteopathic PhysiciansPain MedicinePain Medicine

No ID Information.


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